Just yesterday, I realized that inspite of it being my 20th year of practice in the field of Obstetrics, surprises continue to be surprises and i continue to thank god for they not turning into complications.

Sometimes I realise, as doctors we are under immense stress, because there are so many things that are beyond our control and it is so difficult for us to make our patients realise that.

Probably, the fault lies with us and significantly more with the media that has created a false, un realistic expectation from the field of health care. This misplaced belief that science can achieve everything, and nothing is beyond reach of the modern day science and technology.  If science could help man reach moon then treating the disease in the man should be not that difficult!

Unfortunately it is not true. Still health care is more of an art than pure mathematical science. It is because treatments are all based more on observational studies and learning is based on trail and error. Many a time treatment is instituted based on circumstantial evidence and results cant be expected to be hundred percent.

As you can see there is a lot of gap between expectation and what is feasible!

Yesterday, I had a call from my patient ( let us call her anitha) whom i have been following, since several months and she is now, in the last term of her pregnancy. To be exact she is in late 37th week. Just last week she had her routine check up and everything was hunky dory, having done all the standard tests to be ordered at that stage of pregnancy.

In-fact, I was planning to go for a movie, being a weekend. Anitha said she has this vague feeling. Not sure if it was uterine contraction pain.  She added that she had such discomfort 2 months back too. So she asked me what to do!

I thought for a second while my son was pacing up down, restless as it was time for the movie. Even though her pain is not fitting the picture of typical labour pains and not severe enough to worry, the persistence of the pain since several hours made me edgy.

I told her even though i am not really worried, as she didn’t fall, no water leakage nor any other worrisome symptoms still I wanted her to go to Apollo Cradle and get a NST done.

In a few minutes I got a call – Fetal tachy. Meaning baby heart rate too high. I took the call. Counselled the husband and ordered  for a unit of blood to be crossmatched and asked the Paediatrician for a standby. 

Lucky me, the Operation theatre was clear, and in an hour I was incising the skin. Oh god, do I see the leg of the baby right under the abdominal wall muscles. It is a case of rupture uterus!.

This is one of the several examples that tell us very clearly – All the guidelines and investigations – None are fool proof! Patient, her symptoms, signs and all the tests done just last week none were informative. It was my gut feeling and sheer luck that saved my patient and my peace!